Nursing Elites

1. After the nurse has finished teaching a patient who has a new prescription for exenatide (Byetta), which patient statement indicates that the teaching has been effective?

• A. �I may feel hungrier than usual when I take this medicine.�
• B. �I will not need to worry about hypoglycemia with the Byetta.�
• C. �I should take my daily aspirin at least an hour before the Byetta.�
• D. �I will take the pill at the same time I eat breakfast in the morning.�

Correct answer: C

Rationale:

2. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

• A. Urine dipstick for glucose
• B. Oral glucose tolerance test
• C. Fasting blood glucose level
• D. Glycosylated hemoglobin level

Correct answer: D

Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.

3. A nurse manager is interested in solving a serious conflict that exists among the nursing staff. He uses a strategy that involves allowing the group to explore a number of solutions and come to a consensus on a solution. What strategy for conflict resolution has the manager used?

• A. Integrative decision-making
• B. Win-win
• C. Competing
• D. Confrontation

Correct answer: A

Rationale: The correct answer is A: Integrative decision-making. Integrative decision-making involves allowing a group to explore various solutions and work together to reach a consensus. This strategy focuses on collaboration and finding a solution that meets the needs of all parties involved. Choices B, C, and D are incorrect. 'Win-win' is another term for integrative decision-making, 'Competing' involves pursuing one's own interests at the expense of others, and 'Confrontation' implies a direct conflict rather than a collaborative approach to resolution.

4. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?

• A. Ensure blankets are placed on all four sides of the bed.
• B. Refrain from using restraints during seizure activity.
• C. Position the client laterally during seizure activity.
• D. Have a tongue depressor available at the client's bedside.

Correct answer: D

Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.

5. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.

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